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HomeMy WebLinkAbout11-20-09PETITION FOR PROBATE AND GRANT OF LETTERS REIGISTER OF WILLS OF CUMBERLAND COUNTY, PENNSYLVANIA Estate of _ Scott D. Palmer File Number 21-- ~ p~!'~- l ~ also known as .Deceased Bernadette M. Palmer Petitioner(s), who is/are 18 years of age or older, apply(ies) for: (COMPLETE `A' or `8' BELOW:) ^X A. Probate and Grant of Letters Testamentary and aver that Petitioner(s) is/are the last Will of the Decedent, dated 09/29/2009 and codicil(s) dated Social Security Number 493-50-2922 Executrix named in the State relevant circumstances, e.g., renunciation, death o(executor, eic. Except as follows, Decedent did not marry, was not divorced, and did not have a child born or adopted after execution of the instrument(s) offered for probate, vas not the victim of a killing and was never adjudicated an incapacitated person: B. Grant of Letters of Administration (I app rcable, enter c.t.a.; d. .n. c.t.a.; pedente ne; durance absentia; durance mrnoritate) Petitioner(s) after a proper search has/have ascertained that Decedent left no Will and was survived by the following spouse (if any) and heirs: (If Administration, c.t.a. or d.b.n.c.t.a., enter date of Will in Section A above and complete list of heirs.) ~~ .? ° - I Name onship Residence - - ~~ -':; t-- "_ rr; `..r') - . ~t _.~ --! ~..i (COMPLETE IN ALL CASES:) Attach additional sheets if necessary. Decedent was domiciled at death in Cumberland County, Pennsylvania with his /her last principal residence at 514 Susan Road, Camp Hill, East Pennsboro Township, Cumberland County, PA 17011 *:, t~.~ ~3 `~r'3 (List street address, town/city, township, county, state, ztp code) 514 Susan Road, Camp Hill, East Pennsboro Township, Cumberland Decedent, then 62 years of age, died on 10/28/2009 at County, PA 17011 Decedent a' death owned property with estimated values as follows: (If domiciled in PA) All personal property $ (If not domiciled in PA) Personal property in Pennsylvania $ (If not domiciled in PA) Personal property in County $ Value of real estate in Pennsylvania $ situated as follows: 11.500.00 Wherefore, Petitioner(s) respectfully request(s) the probate of the last Will and Codicil(s) presented with this Petition and the grant of Letters in the appropriate form to the undersigned: d e Signature Typed or printed name and rest enc Bernadette M. Palmer 514 Susan Road Camp HiII, PA 17011 Form RVV-0? Rev. 70-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Paae 1 of 2 Oath of Personal Representative COMMONWEALTH OF PENNSYLVANIA } SS couNTY of Cumberland } the know etdge and)belief of Petitioner(s) and thatlras(persotnale epresentative(s) of the Decedenltl Petitioner(s) will well and t ueybest of administer ttie estate according to law. Sworn to or affirmed and subscribed before me this •~ ' ~ day of - ' A' -~~ i J r- C~~~2_fYJ~~'- Signature of Personal Representative ~ "~ - For the Register °_- ~ ~= --_. t O - ` { -,-~ ~ File Number: ~, tV Deceased' -_.! Estate of Scott D. Palmer Date of Death: 1012812009 Social Security Number: 493-50-2922 .~ ,~ ~>C ~ , in consideration of the foregoing Petition, satisfactory proof AND IVOW, having been presented before me, IT S D CREED that Letters Testamentary are hereby granted to Bernadette M. Palmer in the above estate and that the instrument(s) dated 0912912009 described in the Petition be admitted to probate and filed of record as the last W ill (and Codicil(s)) of Decedent. FEES Letters ............................................ $ •~~~~ Short Certificate(s) ........................ $ ~ ~~ _ Renunciation(s) ............................. $ ~- ~ n Y ~ $ ~ : vv -I ~~I $ jj;,ov ~V~ICtTllrll~l $ 4.S~yt7 $ TOTAL .................................... $ ~ ~• ~,Y1 Signature of Personal Representative N c-.a -~ cw~ A Bogar 8~ Hipp Law Offices Address: One West Main Street Bernadette M. Palmer Shiremanstown, PA 17011 Telephone: 717-737-8761 Page 2 of 2 Fnrm R6N-OZ Rev. 10-13-2006 Copyright (c) 2006 form software only The Lackner Group, Inc. Supreme Court I.D. No.: 19475 1O5A05 REV.13(09i /-~1 ~'~~~ This is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of Health, in accordance with the Vital Statistics Law of 1953, .as amended. WARNING: It is illegal to duplicate this copy by photostat or photograph. Linda A. Caniglia State Registrar r- ~ ~ _ ~. H108-+a3 REV „12308 TYPE i PRINT IM1 PERMANENT BLACK INK ~~ ~i No. HQV 0 9 2009 COMMONWEALTH OF OF HEALTH • VITAL RECORDS Gate CERTIFICATE OF DEATH (See Instructions and examples on reverse) STATE FILE NuMBEIa 2 Sex 3. Social Security Number 6- Dele of peaM (MOrN. day, year) 1. Norm of Decatlent fF~rs1 middle, last, suKix'. l 28 2009 493 - 50-2922 Oct Scott D. Palmer ma e . asl Blnhtlay) Age Il 5 Under 1 ea Untler ' da o. Date of Binh Mpnth, da , e ]. Blnh lace Ci and s~.ale cr loyal n oun[ l [ ne ea. Place of Death (Check onl ° . . Mpnlns Days Fours Mimles 11 /3/1946 Washington DC Hoapilal: ^ Other ii~~tt~~ ^ Oth d S ^ 6,? V s DOA ^ Inpatient ^ ER/OUtpalient pee y Nursing Home 1215t1esitlenee er - Borp Twp. ¢t Death Giry th Bc D Bd Featly Name (If opt instiWtion, give street antl number) 9. Was Decedent of Hispanic Ongin? ~{] No ^ Yes 10 Race'. American Indlar. Black, White. etc- . , 8b- Counry c1 ea Cumberland E. Pennsboro Tw (Il Yea p N C ba (spa[M 51 4 Susan Road Mextan P n R ,oaf white '. t. Dec d . ' ~. ~ccu a an'Knd of work none tlchn• Tqs f k I te. Do not slate at retl 12. J ecetlent eve' n lFe 13. Gecepert .; C ^~ rSpec ly m)' nighesl grade wmpl¢tetl) M 1 I St t s J :~ N1 '..tl, 8. Surr g Spouse ;I` wte g ra ma den rame) W dgwetl Dlvprc¢tl (Syec'ty.' Ki d of W k Knd of Bus nessl Intluslry US. Armed Forces? Elementary /Secondary (0 72) College (1 4 or br) rnadette Yanelli it f.o . ~ c ology state overnment ~7 Yes ^ Nq married ts-D¢[ndpm'a Mailing Addreaa (street [iN. mwn, uate rip [ode) D¢[edern•s Did Depetlern E . Pennsboro Tw ^~e m a n[ Deceeem Laed In p. L~ vas 514 Susan Rd . . Agmal Reaider[e na. stale p~ '°w"eh°' dwi,hin nd , ]e ^ Np, Depedem L ,¢ l-,~ 1 Cti . r sm a c., ; eqm ,?b cgpn ry Acwal t,mns p' Y Father's Name tFirsl midtlle, last, suKx 10 19. Mother's Name (Fist, mltltlle, maiden su!name) . Dou las William Palmer Faith Broadwell 20b Inlortnant's Mailing Atltlress (Street, clay /town state, zip cptlet 20a. Inlormanfs Neme (Type / Pnnt) PA 17011 Camp Hill 514 Susan Road Bernadette Palmer , , f Di n tl =: ^ C 2 M l ^ D n 2tb. Dale of Dispasitlon IMOmh tlay. yea;) 21 c. Place of Dlspostlion (Name of cemetery, crematory or other place) 21n. Location ;Giry )town, slate, zip rode) o eppe ond p 1 a. etro Cremal on ganovallran,slala ~ wa•cremabgnorDnnatmnnmhgriaed i l ^ ~] B N 3 2009 Indinatown Gap National Cemetery Annville, PA pr a ^ Olrer- S e ' by Medl[al Examiner/Coroner? ^ Yes^ No ~ , ov. B [bn as ap[r) zza. Bin P ! zzb. L'[enae vpmb¢r zz .Name and Atltlreaa of Fa[fity 8 Market Plaza Way ~ ~///f~/ ~~r`i ~ ~ FD 011667 L Mal zzi Funeral Home ' 5ign t tl rll'.e) 23b. Le~ Number 23c Ja:e Signsd (MOrlh day, year) la Comp) 23 - I h ntyinq 23a. To the bas: of my knowledge tleath °c,curWd al the Ime date and plc 8 / ~ ' ~ ~ physic an s opt ova table a me of tleaN In ~~( { 66 L 6 a,oo R a 3 5 C~vr, a~ (/ ` [entry gause pf aeam year) 26. W C R f¢ tl 1 U al Exa / Corme~ fo 9 on Olhe~ 1-ar Crenafon n~ ponatlon? Dale Pro unwtl Oeed (MOn1h day , Items 2J 28 muel be cornaeted oY persen 24 Tme of Dea'F a ~ a ~ 0 ^ Y ,~N z •o w1,o ~[ngpn[e¢ tlearl, a .. 5 ~. M Dealn? T U C th l ' e ° baccn f 1 dA ,_py ~o death 2E Oc CAUSE OF DEATH (Sea nstructlons and exa pl ) App•pz mate 'nterval. Pan II. Ert lh 5~ L ; P b try Item 2] Pan I. Enter the h n of events -d'seases njur es. o ompl'catons sat dractty ceusatl the death. DO NOT enter 1a m rat e~enls s.sn as certl ac arrest Onset m Deatn but not resoling n the anderly.,g car se given in Part I. ~] yes c stawing the etiology. List only qna cause on each ine. ^ Nq ~ Unkno esplratory arrest. pr ven..inflar !IUrillalion wilhou; IMMEDIATE CAUSE Final disease ur /~+ ~ ~ R!^~ ~J C /~y~/~~~ ~~!k L~v~ j~~ ~ 29. If Gemale ear with^ as: t re nan~ ~ ~ / r / V ' ' L~ N ~ . p y p g , o eal`J _ ~- contlilipr. resulting In ^ Pregnant at'cme of death a Due :° (o~ as a consequence off. nar_ but Oregnanl'.vilhln 42 days Sequertiallyy list conditions. ~I any. p ^ of tlea~h leading la •h ~ li tea pn hoe a. ppe !o (or as a consequence off. Enter Rre UNDERLYING CAUSE (disease or injury Thal Initiatetl the ~.~ Npt pregnant but pregnant d3 tlays lp 1 year ants asulting In death) LAST. Due :e (or as a ~onsaquence o1)'. pefom tlea:' ~ Unknown I aregnanl wllhin the pas! year d i f Death nn r 31 M 32¢. Date of Inlury (Month, day. year) 32b- Descibe How Inlury Occurretl 32c. Place pl njury. Heine, Farm. Shaer Factory, ' Spa. Was an Aulppsy Pf:np'metl? ndngs 30b. Were Autopsy P Available Prior Ip Cpmpl¢ri0n a e o l/1yaturalJ Hpmicitle Orcice Buildlrg, etc. (a pecily) of Gause pf Deam? N alipn Invesn itl t ^ Pendin ^ A 32tl. Time of Inlury 32e-Inlury et Work? 321 It Transpotte[ien Inlury (SpeorYyl 32g. Localio- of r~jury (Street, city 1 ;Quin, stare) ^ 'Ias/~ Na ^ Ves ^ Nc g g en co ^ 'yes ^ No ^ Orrver/Operator ^ Passenger ^ Pedestnan r~ ^ Suicitle ^ Coultl Nat be Determinetl M. ^ Other -Specify: 33b. Signet 33a. Ge~ifer (check only gnel ~ ~~~ • Certifying physician (Physician certifying cause pl deals whey. another physician has pronouncetl tleatF antl ccmpletetl F,em 231 ^ ~ ~~-..z~ To the best of my knowletlge,death occurred due tothe cause(s)antl rnenner as sletetl--------------------------------- ~ing Ic cause pf peat ~ rnnpuncinq tlealh and cenih (Phvsiaan be!h i i h 3c. License Number ~ - 33tl. Dale Slaned lMOnlh tlay. year) r / ~ , p an ys c ^ Pronouncing and cedifying p Tq the best of my knowletlge, death occurretl at the time, dMe, and place. and due to the cause(s) antl manner as statetl_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ /^ / '^ ~l ~I (~A ~ ~ ` A- ~ ` / / 7 r L .i ~ ^ Medical Examiner) CO^o d Tare, end tlue to the cause s and manner as stated. ^ On the basis of exami anon antl / or investigation. in my opinion, death occurred at the time, tlate, an p () tltlress of Pers°n Whc Compleletl Oause of Dea'F (I'em 2?) Type i P~inl A 34. Name an tl Q /9'• 1 t'ra f'^!ts ~YvfT/L~ ~S, /l~ ~ , 35 R e dpy is K BI I ~ ~ ~ ~ ~ 171 ~ 1 ~ ~ ~ I, AX an I` . ~~ 36a. Dale F,i/led~(MnOnGLh, ]aV. Ye/ar) L : ~% L ! ~-i V t' t i ~ ( /zj l~ ~ Z/ l Pv~Y/~ Y 4 a~ , l` nil P [~ '/7 ~ ~ ~i / J "7~1~/ Disposition Permit Np. ~~~ ~ r~ - r., '"~ ~- f"~ ~r7 ~`7 ~ ~, i i._ 1 _ .«i' .x` ^ ~2a ~.~ .. `.I ~~ ~ ~ .. N ' ~: :Z I ~c~ ~ Iv3~ OATH OF SUBSCRIBING WITNESS(ES) ~, -~ ~.~ __~~ .~ ~ r~ REGISTER OF WILLS ~ ~'' `~' - _-, ~IDc _ .. CUMBERLAND COUNTY, PENNSYLVANIA ~ ~ ~.~ r.~ .. ? ca _:-; ~, _: J -~ ' N Estate of Scott D. Palmer u', Deceased James D. Bogar and Jennifer B. Hipp , (each) a subscribing witness to (Print Name/s) the /®`JVill ©Codicil(s) presented herewith, (each) being duly qualified according to law, depose(s) and say(s) that she / he /they was /were present and saw the above Testator /Testatrix sign the same and that she / he /they the "Testator /Testatrix signed the same and that she / he /they signed as a witness at the request of in her /his presence and in the presence of each other. l ~, __ ~~ urea Janes D gar One West Main Street (Street Address) Shiremanstown, PA 17011 (Citti~, Stclte, Zip) Execrated in Register's Office Swornn to or affirmed and subscribed before me this day of Deputy for Register of Wills f ~sr,~t,~tu~e~ J nnife B. Hipp One We Main Street (Street Address) Shiremanstown, PA 1701 I (City, State, Zip) x ~ -- o c z v a w Executed out of Register's Office ~ ~ ~ a~~ d subscribed n Sworn to or affirmed a z ~~mo ~ ~ Z 1 (~ before me this r~ 7 I ~7 day ~ ¢ ~ ~ ~ ~~ o=Wmo f ~ N ,; o o ' ~' o ~ =mss o m¢ J o ~ W} ~~ ~- ~ ~~ , n Notary Public My Commission Expires: nature and Seal of Notary or other official qualified to (Si g administer oaths. Show date of expiration of Notary's Com mission.] NOT[.: To be taken by Officer authorized to administer oaths. Please have present the original or copy of instrument(s) at time of notarization. Fnrm RN-' U3 rev. 10.13.06 LAST WILL AND TESTAMENT `~'~-, a_. _ ~ , ~_~7 OF -; i.;; c_~ SCOTT D. PALMER , :, ,' I, SCOTT D. PALMER, of Camp Hill, Cumberland, ~%-' `~ `~ N Pennsylvania, make, publish and declare this as and for my Last ~`~ Will and Testament, hereby revoking all other Wills and Codicils heretofore made by me. FIRST: I devise and bequeath all the rest, residue and remainder of my estate of whatever nature and wherever situate, including any property over which I hold power of appointment and together with any insurance policies thereon, unto my wife, BERNADETTE M. PALMER, provided she survives me by sixty (60) days. SECOND: Should my wife, BERNADETTE M. PALMER, prede- cease me or die on or before the sixty-first (61st) day following my death, I devise and bequeath all the rest, residue and remain- der of my estate of whatever nature and wherever situate, includ- ing any property over which I hold power of appointment and together with any insurance policies thereon, in equal shares, to my children, KAREN P. WOODRING and BRYAN S. PALMER, provided that should either of my children predecease me, I give and bequeath ~~uch child's share unto his or her issue per stirpes by x-epresentation, and if there be a failure of same, then I give and bequeath such deceased child's share to my surviving child as provided herein. THIRD: Should any of my grandchildren not have at- t~ained the age of twenty-two (22) years at the time for dis- tribution to him or her, I give, devise and bequeath the share of each such grandchild to my hereinafter named Trustee or Trustees, LN SEPARATE TRUSTS, to hold, manage, invest and reinvest the ;hares so received, and to use and apply from time to time such portion of income and principal for the said grandchild's education (including college, trade school or other similar training or education), as my Trustee or Trustees, in their sole discretion, deem advisable. The Trustee or Trustees, in exercising their discretionary authority with respect to the payment of income or principal of the within Trust to my grand- children, shall take into consideration any income or other resources available to my grandchildren from sources outside this 'T'rust . Any income or principal not so applied shall be dis- t=ributed to each grandchild when he or she attains the age of twenty-two (22) years. In the event any of my grandchildren die prior to the termination of this Trust established herein for t=heir benefit, the interest of said grandchild in said Trust shall cease with any income and principal being divided evenly between or among that deceased grandchild's brothers or sisters or the separate Trusts established hereunder for their benefit <~nd, in the absence of any brothers or sisters, or any Trusts established hereunder for their benefit, to my other grandchil- dren, or the Trusts established hereunder for their benefit, in equal shares. FOURTH: In addition to all powers granted to them by law and by other provisions of this Wiii, I give the Luuciaries acting hereunder the following powers, applicable to all proper- ty, exercisable without court approval and effective until actual distribution of all property: (.A) To sell at public or private sale, or to lease, for any period of time, any real or personal property and to give options for sales, exchanges or leases, for such prices and upon such terms (including credit, with or without security) or conditions as are deemed proper. This includes the power to give 2 legally sufficient instruments for transfer of the property and to receive the proceeds of any disposition of it. (B) To partition, subdivide, or improve real estate and to enter into agreements concerning the partition, subdivi- sion, improvement, zoning or management of real estate and to impose or extinguish restrictions on real estate. (C) To compromise any claim or controversy and to abandon any property which is of little or no value. (D) To invest in all forms of property, including stocks, common trust funds and mortgage investment funds, without restriction to investments authorized for Pennsylvania fiduci- aries, as are deemed proper, without regard to any principle of diversification, risk or productivity. (E) To exercise any option, right or privilege granted i_n insurance policies or in other investments. (F) To exercise any election or privilege given by the Federal and other tax laws, including, but not necessarily being 7_imited to, personal income, gift and estate or inheritance tax ]_aws . (G) To make distributions to my herein named benefici- aries in cash or in kind or partly in each. (H) To borrow money from themselves or others in order ~o pay debts, taxes, or estate or trust ad:,~ini~~ra~~~_~ ~ ~., 1~o protect or improve any property held under my will, and for :investment purposes. (I) To select a mode of payment under any qualified :retirement plan (pension plan, profit sharing plan, employee stock ownership plan, or any other type of qualified plan) to the extent the plan or the law permits them to do so, and ~o exercise any other rights which they may have under the plan, in whatever manner they consider advisable. 3 FIFTH: I nominate and appoint JOHN A. WOODRING, husband of my daughter, KAREN P. WOODRING, as Trustee of the hereinabove described Trusts. I direct that my Trustee shall ~;erve without bond and shall receive fair and reasonable compen- sation. SIXTH: I direct that all inheritance, estate, transfer, succession and death taxes, of any kind whatsoever, which may be payable by reason of my death, whether or not with respect to property passing under this Will, shall be paid out of 1~he principal of my residuary estate. SEVENTH: All interests hereunder, whether principal or :income, which are undistributed and in the possession of the fiduciaries acting hereunder, even though vested or distribut- able, shall not be subject to attachment, execution or sequestra- tion for any debt, contract, obligation or liability of any beneficiary, and furthermore, shall not be subject to pledge, assignment, conveyance or anticipation. EIGHTH: I nominate and appoint my wife, BERNADETTE M. PALMER, Executrix of this, my Last Will and Testament. In the event of the death, resignation or inability to serve for any reason whatsoever of the said BERNADETTE M. PALMER, I nominate and appoint my children, KAREN P. WOODRING and BRYAN S. PALMER, Co-Executors of this, my Last Will and Testament. I airect that my Executrix or Co-Executors, and Trustee, as the case may be, and their successors, shall not be required to post security or bond for the performance of their duties in any jurisdiction. IN WITNESS WHEREOF, I have hereunto set my hand and `' % c:'r~ seal to this, my Last Will and Testament, this c~=.._.,~ day of ,- A~,.~d'~ "~?~." r~~~ P; ;~ . SEAL) ._ "L SCOTT D. PALMER 4 Signed, sealed, published and declared by the above- rLamed Testator as and for his Last Will and Testament in our presence, who, at his request, in his presence and in the presence of each other, have hereunto subscribed our names as attesting witnesses. Address .Address 5 _~ , ~,